In Koraro, Ethiopia, bed nets provided through
the Millennium Villages Project aim to reduce the incidence
of malaria, which kills 3 million people annually, mostly pregnant
women and children.

Photo credit: CNHDE/Sesen

Imagine drawing up the blueprints to save millions of lives, yet
without the means or the currency to make those plans a reality.
This is a fundamental problem faced by many countries ravaged by
malaria, which kills an estimated 3 million annually.

Countries
are formulating robust and achievable plans to effectively prevent
and treat malaria, but are forced to wait for life-prolonging medicines
and other key health commodities to arrive and be distributed.
Despite comprehensive national malaria control plans, a complex process of fund transfers, tenders and approvals and a shortage of key anti-malarial commodities can lead to delays of months or years long.

Ensuring smooth and fast transport of such commodities
between countries and producers is a critical component to any
national malaria strategy. Led by the Earth Institute at Columbia
University, "Breaking
the Bottlenecks," or BTB, is a groundbreaking component of
the Quick
Impact Initiative, a plan endorsed by the United Nations
2005 World Summit, to accelerate anti-malarial efforts in 10 African
countries. Key stakeholders of the initiative, including National
Malaria Control Program Managers, unanimously agree that bottlenecks
related to the disbursement of money from the Global Fund to Fight
AIDS, Tuberculosis and Malaria, and logistics of procurement are
among the most formidable challenges to rolling out prevention
and treatment strategies.

Breaking the Bottlenecks is being lead and coordinated
by Awash Teklehaimanot and Yesim Tozan, project facilitator
from the Malaria Program and former Earth Institute Fellow based
in New York. The BTB team, which also involves experienced health
experts from CHNDE, works with Quick Impact countries to achieve
a rapid scale-up of control efforts by the year 2008. They hope
to expedite direct transfers of commodities to countries by eliminating
monetary transactions among key partners and level the distribution
channels. Breaking the Bottlenecks is a two-pronged approach that
involves:

Working with partners to streamline procedures and practices
for effective implementation of plans and mobilizing resources
for country-led responses.

The in-country technical assistance provided is designed to complement
existing skills of national teams and efforts of partner agencies,
and thus will expand the collective reach of all stakeholders in
participating countries.

Jeffrey D. Sachs, director of the Earth Institute
and a leader of the Malaria Quick Impact Initiative, has called
BTB "the
hotline service" for country program managers. "We’re
the people they call when they need to find out about funding,
or any related issues that need fixing," said Yesim
Tozan.

Teklehaimanot and Tozan are working with the
World Health Organization, the Roll Back Malaria Partnership, the
Global Fund, private companies such as pharmaceuticals and bed
net manufacturers, and others to coordinate "direct transfer of
anti-malarial commodities to countries through pooled procurement,"
said Tozan.

Currently,
CNHDE's office in Addis Ababa is heading the BTB efforts
on the ground. Thanks to generous grants in support of the Quick
Impact Initiative, a new coordinating office in Mali will soon
oversee operations in West African countries. Support from
the Blaustein Foundation and Wealth and Giving donors is directly
helping advance the reach and scope of Breaking the Bottlenecks.

About The Earth Institute The Earth Institute at Columbia University is the world's
leading academic center for the integrated study of Earth, its environment
and society. The Earth Institute builds upon excellence in the core disciplines  earth
sciences, biological sciences, engineering sciences, social sciences and
health sciences  and stresses cross-disciplinary approaches to complex
problems. Through research, training and global partnerships, it mobilizes
science and technology to advance sustainable development, while placing
special emphasis on the needs of the world's poor. For more information,
visit www.earth.columbia.edu.